1. < MAC & Bronchiectasis

Medication for acid reflux/GERD

Posted by kathyhg @kathyhg, Jan 3 2:42pm

I’ve been struggling with acid reflux/GERD for a few years and my doctor has just suggested I take a PPI proton pump inhibitor (such as pantoprazole). He was previously reluctant agree to this, despite recommendation by the gastroenterologist I saw.

I’m sure there have been discussions here related to taking PPI’s with bronchiectasis and Mac but wonder what others have experienced related to this?

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

nana43 | @nana43 | Jan 4 6:45am

Hi Kathy!
I too struggle with GERD, IBS, and H Plyori. I also have Bronchiectasis &MAC. Just taken off big 3 for MAC and starting to feel better and BOOM- H pylori for the 3 rd time and right back on 2 antibiotics and PPI. My pulmonologist doesn’t want me on PPI for a long ( extended) time but it is a must for me if I want to eat!! Had already lost 10 lbs from MAC and now another 5 lbs with this recent GI problem. I am interested to hear anyone else opinions and experience as well.
Hang in There!
Dee

REPLY
kathyhg | @kathyhg | Jan 4 8:16am

Hi Dee,
Thanks for your reply. Did your pulmonologist say why he doesn’t want you on PPI for a long/extended time?
I agree; others might have experience that could be helpful.

REPLY
egayle187 | @egayle187 | Jan 4 8:40am

@kathyhg ... I have been taking PPIs for over 30 years, with no serious side effects. My pulmonologist told me to aggressively treat GERD with everything possible. I also take famotidine and follow a strict diet. My tests from gastro showed excessive acid, greater than a normal person's .
Gerd has caused my adult onset asthma, ruined my voice, destroyed my teeth, and damaged my lungs. I would follow my gastro's advice. I've also had surgery twice to control the acid reflux. Consider your age and general health (I'm 75) when balancing the pros and possible cons of taking the PPIs.

REPLY
vmorton | @vmorton | Jan 4 9:38am

I have suffered with gerds for about 20 years now. I am currently 74 years old. I have taken a PPI for all those years without concern by my pulmonologist and without any problems. I really do have to take it so I would go by your gastro. doc's recommendation.

REPLY
scoop | @scoop | Jan 4 11:16am

PPIs are supposed to used short term but in some cases they are taken longer as necessary.

PPIs do not stop reflux. PPIs turn the stomach acid into stomach alkaline. What PPIs do is turn off the burning because alkaline does not burn so we think our reflux is gone. Less acid in the stomach can create an environment where bacteria are not killed off as regularly. Biologically there is a reason we have stomach acid.

One way people can get NTM (non-tuberculous mycobacteria), it's conjectured, is through reflux. They drink water or other contaminate with NTM (MAC, pseudomonas etc) they aspirate during the night and it goes into the sinuses, voice box, throat, and/or lungs. This happens routinely and then disease sets in. Recently I learned from watching Dr. Huitt's presentation from NJH that normal/healthy people can aspirate during the night. (Thanks to @becleartoday for posting this!)


What can we do about this? Know what your food triggers are and avoid them. Sleep on a high wedge at 30 degrees or on an adjustable bed. Stop food/drink 3 hours before bedtime. Wean off PPIs over a 2-3 month period. It goes something like this:

1 tablet every other day for 2 weeks
1 tablet every 3 days for 3 weeks
1 tablet every 4 days for 4 weeks

REPLY
2 replies
nana43 | @nana43 | Jan 5 7:03am
In reply to @scoop "PPIs are supposed to used short term but in some cases they are taken longer as..." + (show)
@scoop

PPIs are supposed to used short term but in some cases they are taken longer as necessary.

PPIs do not stop reflux. PPIs turn the stomach acid into stomach alkaline. What PPIs do is turn off the burning because alkaline does not burn so we think our reflux is gone. Less acid in the stomach can create an environment where bacteria are not killed off as regularly. Biologically there is a reason we have stomach acid.

One way people can get NTM (non-tuberculous mycobacteria), it's conjectured, is through reflux. They drink water or other contaminate with NTM (MAC, pseudomonas etc) they aspirate during the night and it goes into the sinuses, voice box, throat, and/or lungs. This happens routinely and then disease sets in. Recently I learned from watching Dr. Huitt's presentation from NJH that normal/healthy people can aspirate during the night. (Thanks to @becleartoday for posting this!)


What can we do about this? Know what your food triggers are and avoid them. Sleep on a high wedge at 30 degrees or on an adjustable bed. Stop food/drink 3 hours before bedtime. Wean off PPIs over a 2-3 month period. It goes something like this:

1 tablet every other day for 2 weeks
1 tablet every 3 days for 3 weeks
1 tablet every 4 days for 4 weeks

Jump to this post

Thank you Scoop!
Very informative and helpful!
Dee

REPLY
dulwich | @dulwich | Jan 6 7:26am
In reply to @scoop "PPIs are supposed to used short term but in some cases they are taken longer as..." + (show)
@scoop

PPIs are supposed to used short term but in some cases they are taken longer as necessary.

PPIs do not stop reflux. PPIs turn the stomach acid into stomach alkaline. What PPIs do is turn off the burning because alkaline does not burn so we think our reflux is gone. Less acid in the stomach can create an environment where bacteria are not killed off as regularly. Biologically there is a reason we have stomach acid.

One way people can get NTM (non-tuberculous mycobacteria), it's conjectured, is through reflux. They drink water or other contaminate with NTM (MAC, pseudomonas etc) they aspirate during the night and it goes into the sinuses, voice box, throat, and/or lungs. This happens routinely and then disease sets in. Recently I learned from watching Dr. Huitt's presentation from NJH that normal/healthy people can aspirate during the night. (Thanks to @becleartoday for posting this!)


What can we do about this? Know what your food triggers are and avoid them. Sleep on a high wedge at 30 degrees or on an adjustable bed. Stop food/drink 3 hours before bedtime. Wean off PPIs over a 2-3 month period. It goes something like this:

1 tablet every other day for 2 weeks
1 tablet every 3 days for 3 weeks
1 tablet every 4 days for 4 weeks

Jump to this post

I was able to decrease pantoprazole from 40mg to 20mg daily (lowest pill dosage) over a few weeks of gradual reduction and using extra Pepcid and antacids if needed
I shifted from before breakfast to taking before lunch as really only symptoms later in the day.
I will try to reduce dose further, probably by extending the time between doses rather than skipping a full day when I have a period without travel

REPLY
jml6812 | @jml6812 | Jan 6 8:03am

Thank you Scoop! I’ve had LPR for several years. Likely is the cause of my lung problems. Her explanation made it clearer.

REPLY
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